Zhang Fangfang,Liu Shuang,Li Lianyong,et al.Evolution of concentric reduction after closed reduction for developmental dysplasia of the hip:a prospective serial study of magnetic resonance imaging.[J].Journal of Clinical Pediatric Surgery,,17():736-741.
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Evolution of concentric reduction after closed reduction for developmental dysplasia of the hip:a prospective serial study of magnetic resonance imaging.

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第17卷 Number: 2018 10 Page: 736-741 Column: 专题讨论 Date of publication: 2018-10-25
Author(s):
Zhang Fangfang; Liu Shuang; Li Lianyong; Zhang Lijun.
Department of Pediatric Orthopedics,Affiliated Shengjing Hospital,China Medical University,Shenyang 110004,China.
Keywords:
Hip Joint/GD;  Closed Reduction;  Concentric Reduction;  Magnetic Resonance Imaging
Document code:
A
Abstract:
ObjectiveTo explore the evolution of concentric reduction after closed reduction for developmental dysplasia of the hip (DDH) by a series of magnetic resonance imaging (MRI).MethodsFrom March 2014 to June 2015,the imaging data were prospectively collected for 30 DDH children (35 hips) undergoing safe and stable closed reduction and Spica casting.There were 6 boys and 24 girls with an average age at reduction of 13.7 (3.5-27.6) months.The involved side was left (n=17),right (n=8) and bilateral (n=5).The average followup period was 36.3 (28.5-43.9) months.The joint space was measured by a series of MRI for evaluating the docking status of femoral head.And the values of acetabular index (AI) and centrehead distance discrepancy (CHDD) were measured on anteriorposterior pelvic radiograph.ResultsAmong 35 hips,only three hips became fully concentric immediately after reduction.Twentyfour and 30 hips turned concentric at the end of 6month immobilization and 1 year after reduction respectively.The superior join space was (3.51±1.51) mm at postreduction immediately and (0.79±1.18) mm at 6 months after reduction (t=8.401,P<0.001); the medial space was (3.16±1.17) and (1.28±1.20) mm at immediately and 6 months after reduction respectively (t=6.594,P<0.001).The acetabular index was (34.4±5.3)° prereduction and (23.5±3.7)° at the last follow up (t=16.986,P<0.001).After removing brace,the CHDD of unilateral DDH (25 hips) was (3.28±4.31)% and (3.13±3.09) % at the last follow up (t=0.166,P=0.869).Eight hips belonged to KalamchiMacEwen type I avascular necrosis.ConclusionAchieving safe and stable closed reduction in DDH,a nonconcentric hip may be expected to reach concentric by Spica casting.And the docking process of femoral head is distinctly visible on serial images of MRI.
Last Update: 2018-10-24